Abstract

Most anesthetic and surgical procedures are connected with stress reactions. TIVA is a method most commonly used in laparoscopic cholecystectomy. There exists data suggesting the addition of ketamine to propofol in TIVA for particular surgical procedures. We tried to compare the effect of propofol and propofol with ketamine in TIVA laparoscopic procedures on some hemodynamic and biochemical stress reaction parameters. Our study group comprised 15 patients undergoing laparoscopic cholecystectomy under TIVA anesthesia with propofol (group I)or propofol with ketamine (group II). Heart rate, mean arterial pressure, peripheral hemoglobin saturation, end-tidal carbon dioxide concentration were monitored continuously, and cortisol and glucose blood levels were evaluated 10 and 40 min following intubation and 5 min after extubation, as well as the daily cortisol profile. Our study has demonstrated a lowering of blood pressure and a more pronounced rise in cortisol blood levels during TIVA in group I in comparison to group II, where ketamine was added. . We have demonstrated that ketamine added to propofol stabilizes hemodynamics, decreases the endocrine stress response and allows for the use of lower doses of propofol.

Keywords: anaesthesia, TIVA (total intravenous anesthesia), stress response, Propofol, Ketamine